tbuckley/cabot-search huggingface dataset:
A study of informed consent (IC), age, and cognitive performance (CP) among advanced cancer patients (acp) in phase I trials
Authors: F. J. Hlubocky, E. Larson, G. Sachs, M. S. Lesniak, M. J. Ratain, C. K. Daugherty
Journal: Journal of Clinical Oncology (2008)

9523 Background: Cognitive impairment (CI) among cancer patients has been well described and is believed to be due to various factors, e.g. age and chemotherapy. Prior research indicates that acp participating in phase I clinical trials inadequately understand many elements of IC, but the prevalence of CI has not been well described in this population. Methods: Acp CP was evaluated using a neuropsychological battery designed to assess domains of decisional capacity: Memory (Hopkins Verbal Learning HVLT and Mini-Cognitive Assessment); Executive Functioning (Verbal Fluency and Trail-making A/B); Language (Boston Naming-short); Attention (Digit Span); Comprehension (Auditory Comprehension & WAIS comprehension). Semi-structured interviews also evaluated IC, and included the Hospital Anxiety and Depression Scale (HADS), the BDI-II, and the FACT-COG. Results: To date, a total of 150 acp enrolling in Phase I trials have been studied: median age: 59y (range: 23–83y); 69% male; 85% Caucasian; 73% > HS education. Only 25% of responding acp correctly identified the purpose of Phase I trials. Older acp (>age 55y) were less likely to correctly describe the research purpose of the trial (30% v. 71% p=0.02). Older acp had measurable deficits in CP: Boston (13 ± 1 v.14 ± 0.8, p<0.0); HVLT Total Recall (16 ± 6 v. 24 ± 5, p<0.00) and Discrimination Index (8.3 ± 3 v.11 ± 2, p<0.00); Digit Span (15 ± 5 v. 19 ± 2, p<0.00); Trail-making A (61 ± 28 v. 41 ± 22, p<0.00) & B (178 ± 90 v.109 ± 56, p<0.00). ACP who correctly identified the purpose of a Phase I had greater CP as assessed by memory tasks (38.1 ± 7.9 v. 33 ± 2.6, p=0.04) and greater attentional abilities (21.1 ± 4.3 v. 18.6 ± 2.3, p=0.06).Older acp tended to report more depressive symptoms (14 ± 11 v. 6 ± 5, p<0.00). As well, older acp had FACT-COG scores well below reported means for impact on quality of life (24 ± 7 v. 27 ± 10, p=0.03). Conclusions: Our data strongly indicate that there are clear associations between several measurable domains of CP and understanding of the elements of IC for early phase clinical trials, especially among the elderly. No significant financial relationships to disclose.
Malnutrition and Hunger in the United States
Journal: JAMA (1970)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Incorrect Lower Limit for the Odds Ratio.
Journal: JAMA (1992)

—An error occurred in the Original Contribution entitled "Lymphocytic Choriomeningitis Outbreak Associated With Nude Mice in a Research Institute," published in the March 11,1992, issue ofThe Journal(1992;267:1349-1353). In Table 2 on page 1351, the exact 95% lower limit for the odds ratio for "Cleaning Cages" should be 6.72 [not 3.69].
All Hands
Authors: Ian Wicks
Journal: JAMA (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Controversy over Multiple Chemical Sensitivities
Authors: Robert D. Byers
Journal: Annals of Internal Medicine (1994)

Letters1 February 1994Controversy over Multiple Chemical SensitivitiesRobert D. Byers, MDRobert D. Byers, MDInternational Medicine Associates; Santa Barbara, CA 93105Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-3-199402010-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:How can we, as readers, have confidence in this journal when it publishes the article by Simon and colleagues [1] discussing factors of multiple chemical sensitivity? They receive grants from the Boeing Company, which must have a huge vested interest in disproving the existence of multiple chemical sensitivity.Please explain how this is unbiased.REFERENCE1. Simon GE, Daniell W, Stockbridge H, Claypoole K, Rosenstock L. Immunologic, psychological, and neuropsychological factors in multiple chemical sensitivity: a controlled study. Ann Intern Med. 1993; 119:97-103. Google Scholar Author, Article, and Disclosure InformationAffiliations: International Medicine Associates; Santa Barbara, CA 93105 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1994Volume 120, Issue 3Page: 249-251 Issue Published: 1 February 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
A phase I/II study of docetaxel and atrasentan in men with metastatic hormone-refractory prostate cancer (HRPC)
Authors: D. J. George, J. P. Gockerman, W. Petros, S. Haley, A. D. Franklin, P. A. Creel, A. G. Turner, D. Sleep, H. I. Hurwitz
Journal: Journal of Clinical Oncology (2005)

4667 Background: Docetaxel is first-line treatment for men with metastatic HRPC. New combinations with targeted therapies may improve clinical responses to this regimen. Atrasentan is an endothelin receptor A (ETA) inhibitor with an IC50 in the pM range. Clinical studies suggest atrasentan can delay time to disease progression, bone turnover markers and PSA kinetics. Both drugs are substrates for the metabolic enzyme CYP3A4. Methods: We conducted a Phase I/II trial of docetaxel and atrasentan to define the maximum tolerated dose (MTD), dose limiting toxicity (DLT), pharmacokinetics (PK) and treatment response of this regimen. Patients were treated with docetaxel IV every 3 weeks at doses ranging from 60 to 75 mg/m2. Atrasentan was given orally 10 mg daily starting on Day 3 and taken continuously thereafter. DLT was defined by standard criteria with the exception of neutropenia. Initially, we defined DLT as any grade IV neutropenia, but subsequently redefined DLT as grade IV neutropenia lasting ≥ 7 days. Extensive plasma PK evaluations were conducted for each drug administered alone (Cycle 1 Day 1, 21) and together (Cycle 2 Day 1). Serial samples were evaluated by LC-MS and data were modeled using a standard, two-stage approach. Results: To date, 15 patients have been enrolled over 3 dose levels (9 at 60 mg/m2; 3 at 70 mg/m2 and 3 at 75 mg/m2). Subject demographics include median age of 69, PSA level of 109 ng/ml, hemoglobin of 12.5 g/dl, and KPS of 90%. DLT, initially set as any grade IV neutropenia, was seen at every dose level, however no grade IV neutropenia has lasted ≥ 7 days and the MTD has not been reached. Drug-related grade III/IV toxicities included only neutropenia (42%); other grade I-II toxicities included fatigue, peripheral edema, and nausea. PSA response has been seen in 3/11 evaluable patients. Preliminary PK data show a mean docetaxel terminal half-life of 53 hr and systemic clearance of 52 L/hr, with no obvious difference in values obtained prior to vs. during therapy with atrasentan in patients analyzed to date. Conclusions: Docetaxel and atrasentan together appear to be well tolerated to date. The study is ongoing to more accurately determine response and the potential for pharmacokinetic interactions. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Abbott Laboratories Abbott Pharmaceuticals Abbott Laboratories Aventis
Pretibial rash in Legionella pneumophila pneumonia
Authors: C. M. Helms
Journal: JAMA (1981)

<i>Legionella pneumophila</i>pneumonia developed in a 46-year-old man, 23 days after receiving a cadaveric renal homograft. A painful, nonpruritic, macular, erythematous rash limited to the pretibial surfaces of both legs appeared on the fifth day of illness. Fever, pneumonia, and rash resolved in association with erythromycin lactobionate therapy. (<i>JAMA</i>1981;245:1758-1759)
Different features of Ca2+ oscillations in differentiated and undifferentiated hepatocyte doublets*1, *2
Authors: T KITAMURA
Journal: Hepatology (1995)

Cytosolic free Ca2+ ([Ca2+]i) oscillations are postulated to play a critical role in cellular proliferation. By using doublets of normal rats (NR) and those 18 hours after two-thirds hepatectomy (PHR), we investigated cytosolic free Ca2+ ([Ca2+]i) responses in liver regeneration. Normal rat hepatocyte doublets that retain their bile canaliculi are polarized and well differentiated. PHR doublets, which also retain their bile canaliculi, were characterized as undifferentiated by (1) decreased canalicular secretion of fluorescein-isothiocyanate-labeled glycocholate; (2) increased labeling index of hepatocytes in BrdU staining (∼30%); and (3) impaired transfer of fluorescent dye injected into one cell of the pair to the other. Addition of phenylephrine to NR and PHR doublets in the presence of extracellular Ca2+ resulted in [Ca2+]i oscillations or a nonoscillatory-sustained increase in [Ca2+]i, followed by a gradual return to the baseline. Extracellular Ca2+ was not required for [Ca2+]i, oscillations but was necessary for a sustained increase in [Ca2+]i. Simultaneous addition of prazosin, al-receptor blocker, to doublets immediately abolished these [Ca2+]i, responses. The [Ca2+]i level in each of the adjacent cells was synchronous in sustained increase in [Ca2+]i, but asynchronous in [Ca2+]i oscillations. As the phenylephrine concentration was increased (1 to 100 μmol/L), oscillations were replaced by a sustained increase in [Ca2+]i in NR doublets. In contrast, in PHR doublets, oscillations remained, whereas the frequency of oscillations increased in a dose-dependent manner. These results indicate that the mechanisms of phenylephrineevoked [Ca2+]i responses are different in differentiated and undifferentiated doublets and that the frequency modulation of [Ca2+]i oscillations may be involved in the intracellular signal transduction in the cellular proliferation process during liver regeneration.
BOOK REVIEWS
Journal: JNCI Journal of the National Cancer Institute (1994)

BOOK REVIEWS Get access The Basic Science of Oncology, 2nd Edition . Ian F. Tannock , Richard P. Hill eds. New York : McGraw-Hill , 1992 . 420 pp., illus. $49.95. Reviewed by James Battey [J Natl Cancer Inst 85:1000–1001,1993] JNCI: Journal of the National Cancer Institute, Volume 86, Issue 3, 2 February 1994, Page 235, https://doi.org/10.1093/jnci/86.3.235-b Published: 02 February 1994
MM-008: A Phase 1 Trial Evaluating Pharmacokinetics and Tolerability Of Pomalidomide + Low-Dose Dexamethasone In Patients With Relapsed/Refractory Multiple Myeloma and Renal Impairment
Authors: Jeffrey Matous, David S. Siegel, Hien K. Duong, Claudia Kasserra, Min Chen, Thomas Doerr, Lars Sternas, Mohamed H. Zaki, Christian Jacques, Jatin J. Shah
Journal: Blood (2013)
Editorial Board
Authors: Stephen Mcleod, San Francisco, Daniel Albert, George Bartley, Creig Hoyt, Andrew Schachat, Henry Jampel, Bennie Jeng, Dale Fajardo, May Piotrowski, Meredith Jones Senior, Greg Pelkofski, Jeanine Beisel, Anita Agarwal, Ike Ahmed, Tin Aung, Singapore Balwantray, C Chauhan, Emily Chew, Michael Chiang, Mary Cotch, Mingguang He, Martine Jager
Journal: Ophthalmology (2018)
Antihypertensive Effect of Clonidine
Authors: GADDO ONESTI, ALLAN B. SCHWARTZ, KWAN E. KIM, VIRGILIO PAZ-MARTINEZ, CHARLES SWARTZ
Journal: Circulation Research (1971)

Clonidine hydrochloride is a sympathetic inhibitor with central site of action. The antihypertensive effect in man in the supine position is associated with a decrease in cardiac output and no consistent changes in total peripheral resistance. In the standing position, however, in addition to the decrease in cardiac output, a fall in total peripheral resistance becomes evident. The fall in blood pressure results in no significant alteration in renal blood flow or glomerular filtration rate in the supine position. In the standing position a consistent decrease in renal vascular resistance is seen. In the anesthetized dog the intravenous administration of clonidine produces a significant reduction of renal vein plasma renin activity. Similarly, in patients with essential hypertension oral administration of the drug results in a decrease in peripheral plasma renin activity. In ambulatory essential hypertensive patients treated with clonidine alone in doses of 400 to 900 µg per day, a modest antihypertensive effect is achieved. When clonidine is used with a diuretic, antihypertensive efficacy is achieved in 80% of the patients treated. In higher doses (up to 3,600 µg per day) and in combination with a diuretic, the antihypertensive effect appears to be superior to that of many of the standard agents. Drowsiness and dryness of the mouth are the most frequent and serious side effects with the higher doses.
Opportunistic pneumonia: a stepped approach
Authors: R. C. Bone
Journal: JAMA (1985)

The evaluation of patients with opportunistic lung infection is often a confusing and frustrating ordeal for the physician. A diagnostic and therapeutic dilemma often ensues. The diagnostic dilemma stems from the nonspecificity, costs, and risks of tests designed to delineate the etiology of the infection. The therapeutic dilemma arises because many opportunistic infections have no satisfactory treatment. Additionally, patients often have such a rapidly fatal underlying disease that resorting to invasive procedures to diagnose either a potentially untreatable infection or a pathological manifestation of an underlying disease, although academically interesting, seems to be cruel and unusual punishment. Part of the decision analysis includes the likelihood of rapid deterioration if empiric treatment fails. Thus, no algorithm can be developed that satisfactorily provides a generic approach to this difficult problem. General principles that guide the decision analysis include a rapid history and physical examination, chest roentgenogram, and the collection of respiratory secretions
Lines That Connect: Assessing the Causality Inference in the Case of Particulate Pollution
Authors: David Vincent Bates
Journal: Environmental Health Perspectives (2000)

The question of when it would be appropriate to conclude that the associations between particulate pollution and various outcomes (including mortality) should be judged as causal in nature has been difficult and controversial. Although such a judgment must be subject to revision, the volume of new information and new experimental findings has been so great that such a reevaluation is required at frequent intervals. The useful summary by Gamble [PM(2. 5) and Mortality in Long-Term Prospective Cohort Studies: Cause-Effect or Statistical Associations? Environ Health Perspect 106:535-554 (1998)] of the reasons why a causal inference was, in his opinion, not justified provides a basis for reevaluation in the light of new data. Such a reexamination indicates that the associative evidence is now stronger and that the biologic basis for a number of adverse effects has now been demonstrated. All of the useful guideline criteria customarily applied to such questions seem to have been met, although there is still much to be learned about interactive effects and the possibility of statistical thresholds.
Contact tracing to identify human immunodeficiency virus infection in a rural community
Authors: R. F. Wykoff
Journal: JAMA (1988)

This report describes a contact investigation conducted in rural South Carolina to identify, counsel, and educate persons infected with or exposed to the human immunodeficiency virus (HIV). Starting with one HIV antibody—positive man and his 19 sex contacts, we identified 83 sex contacts of HIV antibody—positive men. Of these, 64 were residents of the county and 63 (98%) agreed to be tested for evidence of HIV infection. Eight (13%) were HIV antibody positive. Thirty-six initially HIV antibody—negative men were reevaluated at a six-month follow-up visit, and three had seroconverted during this time. Of 25 men who reported practicing anal receptive intercourse, 13 (52%) were HIV antibody positive vs none of 43 men who reported strictly anal insertive intercourse. Comparing reported numbers of sexual contacts for the six-month periods before and after our initial investigation, the mean numbers of named sex contacts decreased by 82% for antibody-positive men and 54% for antibody-negative men. None of the men reported using condoms before entering the study; at the six-month follow-up visit, four (80%) of five of the antibody-positive men and 25 (69%) of 36 of the antibody-negative men reported using condoms at least some of the time. (<i>JAMA</i>1988;259:3563-3566)
Error in Affiliation
Authors: Jayshil Patel, Paul Bergl
Journal: JAMA (2018)

To the Editor Dr Cifu 1 stated in his Viewpoint that diagnostic calibration is "…the relationship between diagnostic accuracy and physician confidence in that accuracy" and suggested static and dynamic influences determine diagnostic calibration.We agree with Cifu and Meyer et al 2 that the most worthwhile effort in improving diagnostic calibration is receiving regular feedback on diagnostic accuracy.However, we also advocate practicing metacognition and physicians educating themselves on the myriad cognitive biases that affect diagnostic decisions.These strategies promote the self-awareness that we believe is important for achieving appropriately calibrated confidence and diagnostic excellence.Static and dynamic influences determine diagnostic calibration and other factors such as fatigue, ambient conditions, and team dynamics contribute to diagnostic accuracy.Often, these static and dynamic factors lead physicians down an appropriate cognitive pathway or "cognitive disposition to respond" and to provide a correct diagnosis. 3However, during periods of uncertainty, the summation of numerous static and dynamic factors may promote diagnostic misadventures.Awareness of these factors may be promoted during realtime clinical decision making.For example, by conducting "cognitive and affective autopsies" or a "diagnostic timeout" on rounds, trainees can increase their awareness of static and dynamic factors and review their actual cognitive response.Physicians in practice may find a similar approach helpful by routinely asking themselves the simple question, "What else could this be?"These brief reflections allow learners and practicing clinicians alike to refine their diagnoses in the context of associated dispositions and response.More importantly, they give physicians pause and an opportunity to recognize their level of diagnostic confidence.Cognitive errors or errors in data synthesis or faulty knowledge are purportedly the most common cause of diagnostic error. 4Cognitive errors often occur as a result of overconfidence and overreliance on intuitive modes of thinking. 5Using metacognition forces use of more analytical modes of thinking.Coupled with regular feedback on diagnostic performance, awareness of factors that influence decisions may realign clinicians' diagnostic confidence and accuracy.In effect, diagnostic calibration itself may be recalibrated toward diagnostic harmonization.
Diseases of the Stomach.
Journal: JAMA (1897)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Proceedings of The Thoracic Society
Journal: Thorax (1977)

Diminished beta-receptor respon- siveness (resistance) after chronic treatment with beta- adrenergic agonists has been demonstrated in a number of human and animal tissues but not in the airways of patients with asthma.We have recently demonstrated that resistance to salbutamol can be produced in the airways of normal subjects taking large doses of inhaled salbutamol (Holgate and Tatters- field, 1976) and we have extended this study to investi- gate the metabolic effects of this treatment.
Van Gogh's vision: thujone intoxication
Authors: M. Albert-Puleo
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The theory of Thomas Courtney Lee, MD (1981;245:727), that Vincent Van Gogh's poetic vision may have been influenced by both epilepsy and its treatment with digitalis is interesting, for it points up the importance of considering a pharmacologic component to the artist's unique style. However, as the author readily admits, Van Gogh never had a condition diagnosed as epilepsy and is not known to have been prescribed digitalis. Yet it is well known that Van Gogh was a frequent imbiber of the psychoactive beverage absinthe. The absinthe drinker, such as the one painted by Manet in his painting of the same name, would experience exhaltation, auditory and visual hallucinations, and excitation, and with excessive abuse, unpleasant hallucinations, convulsions, paranoia, acute mania, headache, and hyperesthesia.<sup>1</sup>These effects, combined with Van Gogh's apparent mental illness, certainly played a part in the strange and wonderful visions the artist captured on